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PA Health Policy Update for January 27

The following is an update of selected state health policy developments in Pennsylvania from January 21-27.  (Some of the language used below is taken directly from state documents.)

Harrisburg, PA capital buildingGeneral Assembly

  • The Legislative Budget and Finance Committee (LBFC) met this week and approved the release of a report entitled “Prescription Drug Pricing Under the Medical Assistance Managed Care Program.”  Act 120 of 2020 directed LBFC to conduct a study analyzing prescription drug pricing in the Medical Assistance managed care program; review reimbursement practices by PBMs (pharmacy benefit managers) to pharmacies and to PBMs by MCOs; investigate and compare reimbursement rates by PBMs to independent pharmacies and to chain pharmacies; and study state laws and best practices adopted by other states regarding PBMs and pharmacy reimbursement.  Find the report here.
  • Although the House has not adopted a rules package or formally established standing committees for the 2023-2024 legislation session, the Republican caucus announced its selections for committee chairs this week.  Representatives Kathy Rapp and Tina Pickett will remain Republican chairs of the Health Committee and the Insurance Committee, respectively, while Doyle Heffley will be the new Republican chair of the Human Services Committee.  In addition, Representative Carl Metzger will be the Republican chair of the Professional Licensure Committee, Steven Mentzer will be the Republican chair of the Aging & Older Adult Services Committee, and Linda Schlegel Culver will be the Republican chair of the Children & Youth Committee.  Find the full list of Republican committee chairs here.
  • The state House Democratic Policy Committee convened in Pittsburgh for an informational hearing examining the health care staffing crisis.  Find the meeting agenda and testimony offered during the hearing here.

Department of Human Services

  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin providing guidance for the implementation of Act 65 of 2020, which governs who can provide consent for voluntary mental health treatment of minors who are 14 years of age and less than 18 years of age in both inpatient and outpatient settings.  Act 65 also addresses which individuals may grant consent for the release of a minor’s medical records.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has increased fees for certain ambulance transportation services on the Medical Assistance fee schedule effective with dates of service on or after January 1, 2023.  Find that bulletin here.
  • DHS has published final notice of the assessment amount, the assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the Nursing Facility Assessment Program for FY 2023.  Learn more about which types of facilities to which the assessment applies and how much their 2023 assessment will be from this Pennsylvania Bulletin notice.
  • At the January 26 meeting of the Medical Assistance Advisory Committee, DHS’s Office of Long-Term Living offered a presentation on the efforts of the managed care plans that serve Community HealthChoices members to redetermine the eligibility of their current participants in the wake of the upcoming end of continuous Medicaid eligibility and vaccination rates among Community HealthChoices participants.  Find that presentation here.
  • DHS has updated its physical health managed care enrollment report.

Department of Health

Pennsylvania’s Executive Board has approved a reorganization of the Department of Health.  Find an organizational chart that reflects this reorganization in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania held steady over the past week, remaining higher than prior to Thanksgiving, and the number of new daily deaths rose more than 50 percent over the past week after a decline of 50 percent the week before.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined seven percent last week after a 14 percent decline the previous week; the number on a ventilator because of the virus remained steady; and the number in hospital ICUs fell 15 percent after a six percent decline the week before.
  • The CDC reports a slight decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 25, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; 15 counties are experiencing a substantial rate of community transmission; and the remaining 48 counties are experiencing high rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

 

2023-01-27T21:38:47+00:00January 27th, 2023|COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 27
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PA Health Policy Update for January 20

The following is an update of selected state health policy developments in Pennsylvania from January 14-20.  (Some of the language used below is taken directly from state documents.)

Governor Shapiro

  • Josh Shapiro was sworn in as Pennsylvania’s 48th governor on Tuesday.  Much of the governor’s inaugural speech focused on preserving democracy.  He also highlighted the need for unity and emphasized bringing people together.  Find a transcript of the governor’s speech here.
  • On Wednesday Governor Shapiro issued his first executive order, which prioritizes work experience, skill, and competency for state jobs and highlights that 92 percent of the state’s jobs do not require a four-year college degree.
  • Information about the Shapiro administration’s health-related agency nominees can be found here and a complete list of the Shapiro administration appointments made to date can be found here.

General Assembly

The state Senate convened for voting session this week and the House briefly convened for non-voting session.  Both chambers are now recessed.  The Senate is scheduled to return on Monday, February 27 while the House has yet to release a session calendar.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin rescinding Medical Assistance Bulletin 01-22-78, titled “340B Drug Pricing Program – Dispensing 340B Purchased Drugs,” which was issued on December 22, 2022.  Instead, Medical Assistance Bulletin 99-13-08, titled “340B Drug Pricing Program Provider Requirements and Billing Instructions – Pharmacy Services,” remains in effect.  Go here to see the new bulletin rescinding the December 22 version.
  • DHS has extended its calendar for Remittance Advice (RA) notifications and the delivery of electronic payments and checks into early March.  Find the updated calendar here.
  • DHS has issued a Medical Assistance Bulletin informing providers that it has added CPT codes 0124A, 0154A (Pfizer) and 0134A, 0144A (Moderna) to its fee schedule for the administration of a bivalent booster dose COVID-19 vaccine.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders informing them that it has extended until March 31 its requirement that providers capture consent to treat, service verifications, and approval of treatment plans for Medicaid-funded behavioral health services delivered via telehealth.  At the end of this period providers must have an electronic capability to secure auditable electronic signatures for consent and service verification.  Learn more from OMHSAS’s message to stakeholders.
  • DHS has informed stakeholders that Jennifer (Jen) Smith has joined the department as deputy secretary for OMHSAS.  Smith previously served as Secretary of the Department of Drug and Alcohol Programs.  Learn more from DHS’s message to stakeholders.
  • DHS has posted information about an electronic submission process for Medicaid fee-for-service 180-day exception requests and other claims requiring documentation that will soon be available in the PROMISE portal.  Find that information here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its peer groups, peer group medians, and peer group prices for non-public nursing facilities, including hospital-based nursing facilities and special rehabilitation facilities.  DHS used these peer groups, peer group medians, and peer group prices to determine case-mix rates for non-public nursing facilities for FY 2023.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published its final annual case-mix per diem payment rates for FY 2023 for non-public and county nursing facilities that participate in the Medical Assistance program.  Learn about those rates from this Pennsylvania Bulletin notice.

Department of Health

  • The Department of Health (DOH) has updated its telemedicine interpretive guidance for hospitals.  Find the updated guidance here.
  • DOH has updated its FAQ on innovative care models for hospitals.  Find the updated FAQ here.  The changes, which address critical access hospitals and small rural hospitals, are highlighted in red.
  • DOH has updated its criteria and guidance for establishing an outpatient emergency department.  The changes, which address critical access hospitals, small rural hospitals, and rural emergency hospitals, are highlighted in red.  Find the updated guidance here.
  • DOH also has updated its matrix on how facilities can qualify as an innovative hospital model.  Find the updated matrix here.   Changes again are highlighted in red.
  • DOH has issued guidance requiring prospective new owners of skilled nursing facilities to inform facility residents, representatives, and employees of the possibility of a change of ownership of the facility.  Learn more from this DOH guidance.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania declined 27 percent over the past week and the number of new daily deaths, after a 50 percent increase a week ago, returned this week to its level of recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 declined nearly 14 percent last week after an 11 percent decline the previous week; the number on a ventilator because of the virus rose nine percent; and the number in hospital ICUs fell six percent.
  • The CDC reports a five percent decrease in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 over the past week.
  • As of January 18, four Pennsylvania counties are experiencing a moderate rate of community transmission of COVID-19; eight counties are experiencing a substantial rate of community transmission; and the remaining 55 counties are experiencing high rates of community transmission.

Health Care Cost Containment Council (PHC4)

PHC4 is beginning the verification process for hospital self-pay records for fiscal year 2021.  Its self-pay data reconciliation web application on the PHC4 portal enables hospitals to reconcile their self-pay records, which eventually will be provided to DHS to be used as a part of its calculation of the extraordinary expense portion under Act 77 (the state’s 2001 tobacco settlement law).  Find PHC4’s letter to hospitals here and the portal for self-pay records here.

Stakeholder Events

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – January 26

The Patient Safety Authority will meet virtually on Thursday, January 26 at 1:00.  For information about how to participate in this meeting, see this Pennsylvania Bulletin notice.  Registration is required.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

Department of Health – Organ Donation Advisory Committee Meeting – February 2

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting on Thursday, February 2 at 10:00.  The purpose of the meeting is to review progress in the area of organ and tissue donation in Pennsylvania, recommend education and awareness activities, recommend priorities in expenditures from the Organ and Tissue Donation Awareness Fund, and advise the Department of Health on matters involving administration of that fund.  Interested parties may attend in person or virtually.  For further information about the meeting and how to attend, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – February 3

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Harrisburg on Friday, February 3 at 10:00.  Meeting materials will be sent out before the meeting and will also be available on the board’s web and at the meeting location.  For further information about the meeting and its location, see this Pennsylvania Bulletin notice.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – March 9

The Department of Drug and Alcohol Programs will offer a training program for adolescent service providers on two dates:  March 9 and May 16, both at 8:30.  This training on adolescent ASAM criteria, to be delivered virtually, is designed for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that the March 9 and May 16 sessions will be identical.

Department of Drug and Alcohol Programs – Adolescent ASAM Criteria – May 16

The Department of Drug and Alcohol Programs is offering training on adolescent ASAM criteria, to be delivered virtually, for participants who already understand the foundational aspects of the ASAM criteria.  The purpose of this training is to explore and discuss the adolescent-specific aspects of the ASAM criteria and offer participants a practical focus through lecture, real-world clinical vignettes, and case studies.  The program will be held on May 16 at 8:30.  Continuing education credits are available.  Learn more about the program, including requirements for participation and how to join, from this Department of Drug and Alcohol Programs notice.  Please note that this program is identical to one offered on March 9.

2023-01-20T21:47:06+00:00January 20th, 2023|340b, COVID-19, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 20
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PA Health Policy Update for January 6

The following is an update of selected state health policy developments in Pennsylvania from December 23 through January 6.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Josh Shapiro announced the appointment of his first cabinet-level officials this week, including Akbar Hossain, who will serve as Secretary of Policy and Planning, and Mike Vereb, who will be Secretary of Legislative Affairs.  Hossain is currently the transition team’s executive director and prior to that served as the Shapiro campaign’s policy director.  Vereb, a long-time advisor to Shapiro, previously worked as legislative affairs director for the Office of the Attorney General. Governor-elect Shapiro also announced the appointment of his deputy chiefs of staff.  Lindsey Mauldin, who currently works for Planned Parenthood Pennsylvania, will be Deputy Chief of Staff for Health and Human Services.  Prior to joining Planned Parenthood, Mauldin coordinated Pennsylvania’s COVID-19 pandemic response efforts.  A complete list of the Shapiro-Davis administration appointments made to date may be viewed here.

General Assembly

The General Assembly convened on Tuesday, January 3 to swear in members of the House and Senate and the respective chambers’ presiding officers.  The Senate made history by electing Senator Kim Ward (R-Westmoreland) President Pro Tempore; she is the first woman to hold the position.  Senator Ward also was sworn in as Lieutenant Governor, a position she will hold until Lieutenant Governor-Elect Austin Davis is sworn in on January 17.  After what appeared to be an impasse choosing a Speaker of the state House, Representative Mark Rozzi (D-Berks) was elected by a vote of 115 to 85 to serve as Speaker.  Sixteen Republicans joined Democrats in voting for Rozzi, who committed to being an independent Speaker and not to caucus with either party.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for December.  General Fund revenue collections were $319.9 million, or 8.6 percent, above estimate for the month.  Fiscal year-to-date General Fund collections total $19.7 billion, which is $503.1 million, or 2.6 percent, above estimate.

Centers for Medicare & Medicaid Services

  • CMS has issued guidance on a way for states to address unmet health-related social needs for Medicaid beneficiaries.  This option will help states offer alternative benefits, such as housing and nutrition assistance, through the use of a service or setting that is provided to an enrollee in lieu of a service or setting covered under their state’s Medicaid plan to address a range of unmet health-related social needs to help enrollees maintain their coverage and improve their health outcomes.  Learn more from this CMS news release and this letter from CMS to state Medicaid directors.
  • CMS has issued guidance that creates an easier path to specialty care for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.  For the first time, state Medicaid and CHIP programs will be able to pay specialists directly when a beneficiary’s primary health care provider asks for advice.  For example, if a pediatrician consults with a specialty behavioral health provider about a specific patient’s needs, both providers may be reimbursed for their care – even if the patient is not present.  This move to pay for interprofessional consultations seeks to link routine care with specialty care, enabling more people to benefit from practitioners with specialized knowledge.  Learn more from this CMS news release and the guidance letter CMS sent to state Medicaid directors about this subject.
  • CMS has sent a letter to state Medicaid programs that provides a detailed description of the configuration/implementation plan, testing plan, and testing results that states will need to submit to the federal government when the public health emergency and continuous Medicaid enrollment condition end.  This document seeks to help states understand systems readiness artifacts that are routinely submitted to CMS’s state systems team during IT project and certification reviews.  See the CMS letter here.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform providers that it will reinstate provider enrollment requirements that were in place prior to the COVID-19 public health emergency, including an enrollment application fee, fingerprint-based background checks, and site visits for providers.  Providers temporarily enrolled in the program during the public health emergency who did not satisfy enrollment requirements that were suspended at the time now must satisfy those requirements.  This policy takes effect on February 27.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform providers about the procedures for dispensing 340B drugs to Medical Assistance beneficiaries and about implementation of the Medical Assistance program’s 340B drug exclusion list.  The policies took effect on January 1.  Find the bulletin here.
  • DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has issued a bulletin to inform peer support service providers and Medicaid behavioral health managed care organizations that peer support services identified in beneficiaries’ individual service plans may be provided during transit.  The policy took effect on December 28.  The bulletin also includes revised provider handbook pages.  Find the bulletin here.
  • DHS has updated its COMPASS Community Partners web page with new information about steps that can be taken to help people retain health care coverage after the COVID-19 public health emergency ends, including a new FAQ and an updated public health emergency toolkit.  Learn more about COMPASS Community Partners and these new developments from this message from DHS.
  • DHS has added a new procedure code to the Medical Assistance program fee schedule for a second nurse to shadow a nurse providing private duty/shift nursing to beneficiaries under 21 years of age, effective with dates of service on and after January 1.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a summary of the December 8 meeting of the Medical Assistance Advisory Committee.  Find it here.
  • DHS has updated its telephone directory for those seeking assistance with different Medical Assistance-related issues.  Find the updated directory here.
  • DHS has updated its Medicaid managed care organization directory.
  • DHS has published its physical health Medicaid managed care enrollment report for November.

Department of Health

  • The Department of Health has written to long-term-care facilities to inform them that it will no longer provide short-term crisis staffing support or staffing support for test swabbing missions as of January 14.  It also encourages those facilities to engage with their local LTC RISE partner, which will continue to provide COVID-19 outbreak response consultative support.  Learn more from the department’s letter to long-term-care facilities.
  • The Childhood Blood Lead Test Act signed into law on November 3 took effect on January 2.  The act provides for blood lead assessment and testing of certain children and pregnant women by health care providers; imposes duties on the Department of Health; and requires certain health insurance policies to cover blood lead tests.  Learn more about the new law from this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose 21 percent over the past week.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 is the highest it has been since last February 22; the number on a ventilator because of the virus is the highest it has been since March 9; and the number in hospital ICUs is greater than it has been since March 4.
  • The CDC reports a 15 percent increase in the seven-day average of new hospital admissions in Pennsylvania because of COVID-19 since December 21.
  • As of January 5, one Pennsylvania county – Cameron – is experiencing a low rate of community transmission; 12 counties are experiencing a substantial rate of community transition; and the remaining 54 counties are experiencing high rates of community transmission of COVID-19.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin informing single- county authorities, substance use disorder treatment providers, and other substance use disorder treatment-related organizations that they may be asked to serve on a death review team and that they may be asked to provide records as part of a death review team’s duties.  Find the bulletin here.

The Department of Drug and Alcohol Programs announced an open enrollment period last October for licensed substance use disorder treatment providers in Pennsylvania to submit their information to be included in the Addiction Treatment Locator, Assessment, and Standards Platform, ATLAS.  This open enrollment period has been extended, and will now continue through January 13.  Go here to see the original notice of the open enrollment period and here to see the department’s recent communication on this subject.

Insurance Department

An Insurance Department examination of Capital Blue Cross has identified concerns with claims processing, including claims being denied for lack of prior authorization when prior authorization had already been obtained, and a coordination of benefits issue that has since been updated.  The examination also reported additional Unfair Insurance Practices Act violations involving unclear communication with members.  The exam also found mental health parity violations.  Learn more about why the department conducted the review, what it found, and how it is addressing the problems it identified from this news release.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – January 12

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a public meeting on Thursday, January 12 at 10:00.  For additional information about the session, see this Pennsylvania Bulletin notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – January 18

The Department of Health’s Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, January 18 at 9:00.  Interested parties may attend in person or virtually.  Learn more about the committee, where the meeting will be held, and how to participate virtually from this Pennsylvania Bulletin notice.

Department of Health – Renal Disease Advisory Committee – January 20

The Department of  Health’s Renal Disease Advisory Committee will meet in Harrisburg on Friday, January 20 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Consumer Subcommittee – January 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, January 25 at 1:00.  Go here to register to participate virtually.

Medical Assistance Advisory Committee – January 26

The Medical Assistance Advisory Committee will meet virtually on Thursday, January 26 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – January 26

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, January 26 at 10:00.  To learn more about the committee, the location of the meeting, and how to join the meeting virtually, see this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – January 31

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will meet virtually on Tuesday, January 31 at 9:30.  For more information about the board and how to join the meeting, see this Pennsylvania Bulletin notice.

Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – February 1

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will hold a public meeting on Wednesday, February 1 at 10:00.  Interested parties may attend in person or virtually.  Go here for further information about the meeting, its location, and how to participate virtually.

 

2023-01-06T21:54:53+00:00January 6th, 2023|340b, COVID-19, Federal Medicaid issues, health equity, Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for January 6
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PA Health Policy Update for Friday, December 23

The following is an update of selected state health policy developments in Pennsylvania for the week of December 19-23, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin informing providers about new procedures for dispensing 340B-purchased drugs to Medical Assistance beneficiaries and about the implementation of the program’s 340B drug exclusion list.  Find the bulletin here.  Find the policies this new bulletin replaces here.
  • DHS has extended its schedule for sending Remittance Advice documents, Medicaid payment checks, and electronic transfers of payments into early February.  Find the updated schedule here.
  • DHS has announced that it will add several prescription drugs to the Medical Assistance program’s list of services and items requiring prior authorization:  corticotropin; targeted systemic immunomodulators for atopic dermatitis, designated as preferred on the program’s preferred drug list (PDL); PCSK9 inhibitor lipotropics, designated as preferred on the PDL; and obesity treatment agents designated as preferred on the PDL.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has posted revisions of the participating drug company list for the Medicaid drug rebate program.
  • DHS has announced its intent to allocate funds in FY 2023 for several classes of inpatient disproportionate share hospital (DSH) payments (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  It does not intend to otherwise change the qualifying criteria or payment methodology for these payments.  See the announcement, including information about the different purposes for which Medicaid DSH payments will be made, in this Pennsylvania Bulletin notice.
  • DHS has circulated the following materials from the December 7 meeting of the Medical Assistance Advisory Committee meeting.

Department of Health

  • The Department of Health (DOH) has announced that Pennsylvania will receive $98 million in federal funding to enhance public health infrastructure, including staffing, health planning, and equity and data modernization efforts.  A portion of the funding, from the CDC’s Public Health Infrastructure grant program will be allocated to 10 county and municipal health departments.   Learn more from this Department of Health news release.
  • DOH has issued a health advisory informing providers to be aware of possible increases in group A streptococcal infections.  The alert also informs providers about symptoms, testing, and treatment; provides instructions for laboratories that identify cases; and reminds providers and laboratories that they are required to report such cases to DOH.  Find the alert here.
  • DOH has issued a health advisory with interim guidance for clinicians on how to prioritize antiviral flu treatment at a time when there is limited availability of the drug oseltamivir (Tamiflu).  Find the advisory here.
  • DOH has revised long-term-care nursing facility regulations recently approved by the Independent Regulatory Review Commission to correct typographic errors.  Find the revised, final regulations in this Pennsylvania Bulletin notice.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and in hospital ICUs remained steady over the past week but the number on ventilators rose 17 percent.
  • The CDC reports no change over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 21, 46 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 15 were experiencing substantial rates of community transmission; and six counties were experiencing a moderate rate of community transmission.
  • As 2022 draws to a close, Pennsylvania has now experienced 3.4 million confirmed, reported cases of COVID-19 and suffered nearly 49,000 deaths from the virus.
2022-12-23T21:11:29+00:00December 23rd, 2022|COVID-19, long-term care, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 23
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PA Health Policy Update for Friday, December 16

The following is an update of selected state health policy developments in Pennsylvania for the week of December 12-16, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

The Department of Human Services has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information that will be needed, as of January 9, to evaluate the medical necessity of prescriptions for:

Department of Health

  • The Department of Health (DOH) is working to implement Act 128 of 2022, which requires temporary health care services agencies to register with DOH.  Under the act, temporary health care services agencies are agencies that provide temporary health care personnel (RNs, LPNs, nurse aides, or direct care staff) to long-term-care nursing facilities, personal care homes, or assisted living residences.  DOH has developed a survey for long-term-care facility administrators so it can compile information about temporary health care services agencies operating in Pennsylvania.  Long-term-care facility officials can go here to complete the brief survey.
  • DOH has issued an alert advising providers of an outbreak of measles in neighboring Ohio, informing providers about the symptoms they should look for among possible measles patients and how to prevent, test for, and treat measles.  The alert also reminds providers that they are required to report measles cases to the state.  Learn more from this health alert.
  • DOH has issued an alert updating providers on its latest guidance for treating COVID-19.  The alert notes that the most common strains of the virus cannot be treated by the monoclonal antibodies that were effective against earlier strains and that the federal government currently authorizes no such products for use in treating COVID-19 patients.  Despite this, selected anti-viral therapeutics are still available to treat such patients.  Learn more from this health alert.

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs rose, but just slightly, over the past week.
  • The CDC reports a modest increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 14, 52 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 14 were experiencing substantial rates of community transmission; and one county was experiencing a moderate rate of community transmission.  This represents deterioration from the previous week, when 39 Pennsylvania counties experienced high rates of community transmission of COVID-19, 25 experienced substantial rates of community transmission, and three experienced moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs recommends that businesses that provide addiction treatment and supports consider training employees and volunteers regularly on preparing for and responding to an active shooter incident.  Learn more from this message from the department to stakeholders.

Pennsylvania Health Care Cost Containment Council

PHC4 has released “Hospital Performance Report – October 2020 through September 2021 Data,” which presents information about the performance of Pennsylvania acute-care hospitals for 13 common medical conditions.  Among the factors reported are hospital-specific mortality, 30-day readmission ratings, case volume, and hospital charges for patients between October 1, 2020 and September 30, 2021.  The report also looks at changes in statewide rates over time.  For additional information see PHC4’s news release; a report summary; an introduction to the report; a summary of key findings; downloadable data sets; technical notes; and data about Medicare payments.

2022-12-16T21:54:49+00:00December 16th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for Friday, December 16
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PA Health Policy Update for Friday, December 9

The following is an update of selected state health policy developments in Pennsylvania for the week of December 5-9, 2022.  (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Shapiro announced that he will appoint Uri Monson, the chief financial officer of the School District of Philadelphia, as Budget Secretary.  He also announced Jennifer Selber will be appointed General Counsel and Larry Hailsham, Jr. will be Executive Deputy Chief of Staff.  Selber currently serves as the Executive Deputy Attorney General of Pennsylvania in charge of the criminal division and Hailsham most recently served as the Shapiro campaign’s political director.

General Assembly

  • Democrats and Republicans continue to struggle over control of the state House. On Wednesday Representative Joanna McClinton (D-Philadelphia) was sworn in during an unannounced ceremony as majority leader.  Republicans swiftly denounced the swearing-in as an “illegitimate power grab.”  In addition, Representative Summer Lee (D-Allegheny County) and Representative Austin Davis (D-Allegheny County) formally submitted their resignations on Wednesday.  At the same time they won re-election to those seats Ms. Summer was elected to Congress and Mr. Davis was elected Lieutenant Governor.  Their resignations, along with the passing of Representative Tony DeLuca (D-Allegheny County), make the current breakdown in the state House 101 Republicans and 99 Democrats.
  • The state Senate released its 2023 session calendar through June.  The calendar can be viewed here.

Department of Human Services

COVID-19:  By the Numbers                          

  • The number of new COVID-19 cases reported daily in Pennsylvania rose nearly 30 percent in the past week, an increase possibly attributable to social gatherings over the Thanksgiving holiday.  The number of new deaths remains within the usual range for recent months.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively unchanged.
  • The CDC reports a 22 percent increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
  • As of December 7, 39 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 25 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.  This is almost identical to the previous week.

Department of Drug and Alcohol Programs

  • The Department of Drug and Alcohol Programs has issued an information bulletin explaining that as a result of a new Pennsylvania law passed last month, private and public treatment and rehabilitation facilities may not deny addiction treatment to individuals based solely on a negative result on a drug test.  This policy takes effect on January 1.  Learn more from this information bulletin.
  • The Department of Drug and Alcohol Programs has announced that it has awarded nearly $19 million in grant funding through its substance use disorder loan repayment program to help substance use disorder treatment professionals repay their outstanding qualifying educational loans.  More than 280 practitioners, including case managers, counselors, licensed social workers, physician assistants, and registered nurses, shared in the funding.  Learn more from this department news release.

State Board of Nursing

The State Board of Nursing proposes amending its process for reactivating nursing licenses.  Learn more from this Pennsylvania Bulletin notice.  Public comments on the proposed changes are due within 30 days.

2022-12-09T21:00:26+00:00December 9th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, December 9
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PA Health Policy Update for Friday, November 10

The following is an update of selected state health policy developments in Pennsylvania for the week of November 7-10, 2022.  (Some of the language used below is taken directly from state documents.)

2022 Election Update

While the results are not official, current Democratic Lieutenant Governor John Fetterman has defeated Republican Mehmet Oz to replace retiring U.S. Senator Pat Toomey. Pennsylvania’s congressional incumbents all won another term. The state’s two open congressional seats (PA-12 and PA-17) were captured by Summer Lee (D) and Chris Deluzio (D), respectively.

At the state level, Democrat Josh Shapiro, the state’s current Attorney General, defeated Republican State Senator Doug Mastriano and will be Pennsylvania’s next governor.

Republicans will retain control of the state Senate with 28 of the chamber’s 50 seats; they have been in the majority in the Senate since 1994.  In an unanticipated outcome, Democrats made significant gains in the state House, and as of Thursday afternoon, November 10, are in striking distance of having a majority.  A handful of House races remain too close to officially call and may be headed for a recount. Except for a four-year period from 2007 through 2010, Republicans have been in the majority in the House since 1995.

Come January, Pennsylvania will have a new governor, a vacancy at Attorney General, and nearly a quarter of the General Assembly’s members will be new so there will be changes in caucus and committee leadership.

General Assembly

As of Thursday afternoon, the state House is schedule to return to session on Monday, November 14 and the Senate is scheduled to return on Tuesday, November 15.

The Senate Health and Human Services Committee will hold a public hearing next Tuesday, November 15th at 10:00 a.m.. to review the recently released Behavioral Health Commission report. The hearing can be livestreamed here.

Department of Human Services

Department of Health

The Department of Health has written to nursing home administrators to inform them that temporary nurse aides (TNAs) hired on or before June 6, 2022 have until the end of the federal public health emergency or April 5, 2023, whichever date comes first, to successfully pass the nurse aide exams and have their name enrolled on the Nurse Aide Registry.  Find that letter here.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania continues to fall in the 1700-1800 a day range while the number of deaths is generally between 17 and 20 a day.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs because of the disease remained relatively steady over the past week.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

2022-11-14T21:35:19+00:00November 10th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, November 10
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PA Health Policy Update for Friday, November 4

The following is an update of selected state health policy developments in Pennsylvania for the week of October 31 to November 4, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf signed 66 bills into law this week and vetoed one, Senate Bill 736.  The following is a selection of health care-related bills signed into law by the governor.

  • House Bill 220, which is now Act 101 of 2022, specifies that a person does not need to test positive for drugs to begin addiction treatment.
  • House Bill 1393, which is now Act 111 of 2022, seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use.
  • House Bill 2293, which is now Act 128 of 2022, requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
  • House Bill 2527, which is now Act 135 of 2022, expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.
  • House Bill 2800, which is now Act 143 of 2022, amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • Senate Bill 225, which is now Act 146 of 2022, streamlines and standardizes the process for prior authorization of medical services.  The Insurance Department has issued a news release about this new law.
  • Senate Bill 522, which is now Act 150 of 2022, requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.

General Election

The 2022 general election will be held on Tuesday, November 8.  Pennsylvanians will be voting for one U.S. Senate seat, 17 U.S. House of Representatives seats, governor, half of the 50 state Senate seats, and all 203 state House seats.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals’ response to COVID-19 to reflect the October 31 expiration of the COVID-19 state regulatory waivers and flexibilities. Find the updated guidance here.  At the same time, the Department of Human Services (DHS) has updated its list of regulations that have been suspended in response to the COVID-19 public health emergency.  Find the updated list here and scroll down to see the latest regulation suspensions that have expired; they are highlighted in red.
  • DOH has issued a health advisory about the increase in the number of cases of respiratory syncytial virus (RSV) nationally and in the state.  The alert describes the virus, outlines testing and treatment recommendations, and asks providers to report laboratory-confirmed RSV cases to DOH through Pennsylvania’s electronic reportable disease surveillance system,  PA-NEDSS.  It also urges providers to report outbreaks or clusters of severe respiratory illness, regardless of etiology, to the state and local health departments.  Find the advisory here.
  • DOH has issued a news release outlining the changes in the state’s regulations for skilled nursing facilities that have been approved by Pennsylvania’s Independent Regulatory Review Commission and now await review by the state’s Attorney General.
  • DOH has released a request for applications for its Long-Term Care Quality Investment Pilot, which will distribute approximately $11.7 million in federal funds to long-term-care facilities, including skilled nursing facilities, personal care homes, assisted living facilities, and intermediate-care facilities for the purpose of building resilience.  These funds are designed to be invested in key areas such as workforce development and retention, infection prevention control, emergency preparedness, and improvements to facility infrastructure.  To apply for this funding, facilities must participate in the state’s LTC RISE program’s quality improvement projects and cannot be located in Philadelphia.  Find the state’s request for applications here and learn about LTC RISE here.  The application deadline is December 31.

Department of Human Services

  • The Department of Human Services (DHS) announced that Pennsylvania has received approval from the federal Centers for Medicare & Medicaid Services (CMS) to extend its postpartum coverage period for mothers and birthing people eligible for Medicaid because of their pregnancy from 60 days to 12 months.  Learn more from this DHS news release.
  • DHS has extended into early January of 2023 its Remittance Advice calendar for mailing checks and electronically sending Medicaid payments.  Find the updated calendar here.
  • In response to the passage and signing of House Bill 1630 (now Act 98), which addresses, among other things, the delivery of some mental health and substance use services, DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS) has written to stakeholders to advise them of some of the new law’s implications and to list the sections of the Pennsylvania Code the new law repeals.  Find the OMHSAS message to stakeholders here.
  • DHS has issued a Medical Assistance Bulletin advising providers who are not a recognized provider type under the Medical Assistance program that they now may enroll in the program for the purpose of billing for cost-sharing for services provided to beneficiaries who receive both Medicare and Medicaid.  This bulletin also provides information on how to complete and submit an enrollment application.  Find the bulletin here.
  • DHS has added a procedure code to the Medical Assistance fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information needed to evaluate the medical necessity of prescriptions for:

These requirements take effect on January 9, 2023.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose 12 percent after a decline of 12 percent the week before; the number of deaths rose slightly.  The state is averaging more than 1800 new reported cases a day and about 19 daily deaths.
  • According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs (172) is at its highest level since early March.
  • The CDC reports a modest increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a 15 percent decrease last week.
  • As of November 4, 54 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 13 are experiencing substantial rates of community transmission; and Cameron County is experiencing a moderate rates of community transmission.

Stakeholder Events

Department of Health – State Child Death Review Team – November 9

The Department of Health’s State Child Death Review Team will hold a public meeting in Harrisburg on Wednesday, November 9 at 10:00.  The state’s Child Death Review Program provides training and technical assistance to local Child Death Review teams.  This meeting will focus on suicide deaths.  For information about the location of the meeting and the Child Death Review Team, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00.  Interested parties can join the meeting in person or via webinar.  For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00.  Go here to register to participate.

 

2022-11-04T20:15:28+00:00November 4th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off on PA Health Policy Update for Friday, November 4
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PA Health Policy Update for Friday, October 21

The following is an update of selected state health policy developments in Pennsylvania for the week of October 17-21, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The state Senate convened for session this week.  The following is an overview of selected health-related legislation that received consideration.

  • The Senate passed on third and final consideration Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate passed Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.  The bill was received in the House and referred to the Insurance Committee.
  • The Senate Health & Human Services Committee met on Tuesday, October 18 and favorably reported the following bills.
    • Senate Resolution 352 requires the Joint State Government Commission to study the specific data, calculations, and mechanisms the Department of Human Services uses to determine the capitation rate paid to drug and alcohol treatment providers in Pennsylvania.
    • Senate Bill 359 requires the Secretary of DHS to apply for a waiver that would extend Medicaid coverage for pregnancy-related and postpartum medical assistance for up to ten additional months.
    • Senate Bill 1136 amends the Vital Statistics Law to expressly include the Legislative Budget and Finance Committee as a government entity and to clarify that it may have access to vital statistics for research purposes.
    • Senate Bill 1358 places certain restrictions on non-compete clauses for health care practitioners and requires patient notification.
    • House Bill 293 allows FDA-approved anti-obesity drugs to be considered a compensable service under the state’s Medicaid program.
    • House Bill 1443 permits certain diagnostic laboratory services to be directly marketed to Pennsylvania consumers.
    • House Bill 1630 and Senate Bill 917 grant the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers (PBMs) in Medicaid.
    • House Bill 2293 requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.
    • House Bill 2357 prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2530 ends the practice of prudent pay in DHS’s Office of Developmental Programs.
  • The Senate Consumer Protection & Professional Licensure met on Tuesday, October 18 and favorably reported, among other bills, House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
  • The Senate Aging & Youth Committee met on Tuesday, October 18 and favorably reported House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging.
  • The state House and Senate will convene for voting session next Monday (10/24), Tuesday (10/25), and Wednesday (10/26).

Department of Human Services

  • The Department of Human Services (DHS)  has extended its calendar for issuing Medical Assistance remittance advice notifications, mailing checks, and making electronic transfers into early December.  Find the updated calendar here.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT code 0094A to the Medical Assistance program fee schedule for the administration of a booster dose of the Moderna COVID-19 vaccine.  Find that bulletin here.
  • DHS has announced the addition of new procedure codes to the Medical Assistance fee schedule for the administration of a pediatric booster dose or a pediatric dose of Pfizer and Moderna COVID-19 vaccines.  Find the codes, the payment rates, and the effective dates of the new codes in this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to promote the continuation of quality medical services to individuals enrolled in the Pennsylvania Medical Assistance program and provide financial relief to hospitals during the COVID-19 pandemic.  DHS is not otherwise changing the qualifying criteria or payment methodology for these payments.  The FY 2021-2022 impact of these payments is $70 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has published a final notice of its funding allocation for FY 2021-2022 to establish a new class of supplemental payments to qualifying acute-care general hospitals that provide a high volume of services to Medical Assistance-eligible and low-income populations in non-rural medically underserved areas.  The FY 2021-2022 budget impact of these payments is $5.283 million in total funds.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has announced that the Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange, has successfully transitioned to a new, cloud-based system that it believes will improve health care delivery across the state.  The P3N is a centralized platform that connects independent health information organizations (HIOs) and facilitates information-sharing, connecting health care providers that participate with the goal of improving care coordination and outcomes for patients.  Providers connected to a P3N-certified HIO can find patient medical records anywhere on the P3N network and receive notifications when their patients obtain services from other providers in the state, such as an emergency room visit.  Learn more about the new system and its capabilities from this DHS news release.
  • Kristen Houser has resigned as deputy secretary of DHS’s Office of Mental Health and Substance Abuse Services (OMHSAS).  Dr. Dale Adair will serve as acting deputy secretary.

COVID-19:  By the Numbers

  • According to the CDC, the number of new COVID-19 cases reported in Pennsylvania over the past week rose slightly after several weeks of declines; the number of deaths was unchanged.
  • According to the Department of Health, the number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus remains relatively steady while the CDC reports a nine percent increase in the seven-day rolling average of new daily COVID-19 hospital admissions after a comparable decrease the previous week.
  • Sixty-two of Pennsylvania’s 67 counties continue to experience a high rate of community transmission of reported COVID-19 cases.  The remaining five counties – Adams, Centre, Philadelphia, Snyder, and Sullivan – are experiencing moderate rates of community transmission.

Stakeholder Events

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – October 26

The Medical Assistance Advisory Committee’s Consumer Subcommittee will meet virtually on Wednesday, October 26 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – October 27

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, October 27 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

DHS – Trauma-Informed Management – October 27

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on trauma-informed management for skilled nursing facilities.  The webinar will be held on Thursday, October 27 at 2:00.  Learn more about the webinar, the skilled nursing professionals to whom it is directed, and how to participate from this notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Support Subcommittee – November 2

The Managed Long-Term Services and Support Subcommittee of DHS’s Medical Assistance Advisory Committee will meet publicly on Wednesday, November 2 at 10:00 in Harrisburg.  Interested parties may attend in person or via webinar; those participating through the webinar must register in advance.  For information about the location of the meeting, how to join it virtually, how to register, and how to offer comments or submit questions, see this DHS notice.

Department of Health – Human Immunodeficiency Virus Community Prevention Planning Committee – November 2

The Department of Health’s Human Immunodeficiency Virus Community Prevention Planning Committee will hold a public meeting in Harrisburg on Wednesday, November 2 at 9:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Organ Donation Advisory Committee Meeting – November 3

The Department of Health’s Organ Donation Advisory Committee will hold a public meeting in Harrisburg on Thursday, November 3 at 10:00.  Interested parties can participate in person or virtually.  For further information about the committee, the meeting, and how to participate, see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board Meeting – November 4

The Department of Health’s Traumatic Brain Injury Advisory Board will hold a public meeting in Camp Hill, PA on Friday, November 4 at 10:00.  For information about the role of the board, the purpose of the meeting, and the location of the meeting, see this Pennsylvania Bulletin notice.

 

2022-10-21T20:30:06+00:00October 21st, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for Friday, October 21
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PA Health Policy Update for Friday, September 30

The following is an update of selected state health policy developments in Pennsylvania for the week of September 26-30, 2022.  (Some of the language used below is taken directly from state documents.)

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that it has added CPT codes for administering COVID-19 pediatric boosters.  The new codes can be used immediately.  Find that bulletin here.
  • DHS has issued a Medical Assistance Bulletin to advise providers of the addition of procedure codes to the Medical Assistance fee schedule for the provision of private duty nursing services, which are provided through home health agencies to beneficiaries under 21 years of age.  The additions take effect on October 1.  Find that bulletin here.
  • DHS’s Office of Long-Term Living has launched its American Rescue Plan Act of 2021 funding reporting portal.  The online portal will be available beginning on September 30, 2022 for Office of Long-Term Living providers to submit costs associated with American Rescue Plan funding distributed in 2021, as required by the state.  Learn more from this announcement of the portal’s launch and from DHS’s guide on to how to use the portal.
  • DHS has updated its data on physical health HealthChoices enrollment and participation in the Medical Assistance Transportation Program.  Find the update here.

Department of Health

  • The Department of Health (DOH) has issued new guidance for health care providers and their employees who have been exposed to or contracted COVID-19.  The first addresses the return to work for health care workers with confirmed or suspected cases of COVID-19 and the second describes work restrictions for health care workers who have been exposed to COVID-19.  Both are introduced to align state standards with recently revised guidance from the federal Centers for Disease Control and Prevention.
  • DOH has updated its definition of how it defines whether individuals are up to date on their COVID-19 vaccinations.  Go here to see the updated definition and learn about the department’s rationale for this change.
  • DOH has issued a health alert to notify providers, laboratories, infection control specialists, and local health departments about an unvaccinated adult with poliovirus infection and acute flaccid paralysis.  Wastewater testing in treatment facilities in Rockland County, New York, which is adjacent to Pennsylvania, and surrounding counties also identified related poliovirus, indicating that the virus is circulating in the community and others may become ill.  DOH urges providers to consider polio as a possible cause of sudden onset of limb, facial, oropharyngeal, or respiratory muscle weakness; to contact their local or state health department to discuss such cases; and to encourage any unvaccinated patients to receive polio vaccines.  Learn more from this health alert.

COVID-19:  By the Numbers

  • The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady:  roughly 2500 new daily cases and 20 new deaths with weekly variances of 10-20 percent.
  • The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
  • According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 191 admissions a day over the past week, a slight reduction from the previous week.
  • Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19.  Snyder County is currently experiencing “only” a substantial rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued Licensing Alert 02-22 to inform drug treatment programs about the process for establishing mobile narcotic treatment programs.  Find the alert here.

Insurance Department

The state Insurance Department has released Pennsylvania’s 2023 individual and small group Affordable Care Act health insurance rates.  The release also shares changes in the number of insurers offering coverage to Pennsylvanians and offers information about federal rate subsidies.  Learn about the newly released information and find a link to the rates and insurers themselves in this Insurance Department news release.

Monkeypox

  • The CDC has posted an updated map showing the distribution of 25,613 confirmed cases of monkeypox in the U.S. as of September 29, up only slightly from 23,364 cases on September 21.  713 of those cases were in Pennsylvania, up from 684 a week ago.
  • As of September 25, 475 of those Pennsylvania monkeypox cases were in Philadelphia, up from 446 on September 18.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Stakeholder Events

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities.  Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually.  For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00.  Learn more about the webinar and how to register to participate from this notice.

DHS – Long-Term Care Workforce Motivation – October 13

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how to express appreciation for long-term-care workers.  The webinar will be held on Thursday, October 13 at 2:00.  Learn more, including how to participate, from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives.  The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention.  Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

Department of Health – Special Pharmaceutical Benefits Program – Advisory Council – October 27

The Department of Health’s Special Pharmaceutical Benefits Program Advisory Council will meet in Harrisburg on Thursday, October 27 at 10:00.  Interested individuals may attend in person or participate virtually.  For information on the location of the meeting and how to join the meeting virtually, see this Department of Health notice.

2022-09-30T21:16:03+00:00September 30th, 2022|COVID-19, HealthChoices, long-term care, Medical Assistance Bulletin, Meetings and notices|Comments Off on PA Health Policy Update for Friday, September 30
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Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • P: (717) 234-6970

  • 2020 Safety-Net Association of Pennsylvania

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